BENIGN BREAST TUMOR

Fibroadenomas are benign tumors composed of stromal and epithelial elements. These tumors are commonly seen in young women; less than 25 years old according Lee (2011). Multiple or complex fibroadenomas may indicate a slightly increased risk for breast cancer; the relative risk of patients with such fibroadenomas is approximately twice that of patients of similar age without fibroadenomas (Roubidoux, 2011), although other authors do not consider a breast cancer precursor (Lee, Bushan, Tolles, & Hofmann, 2011).

Intraductal papilloma is a small benign proliferative tumor that grows in lactiferous ducts, consists of a branching fibrovascular core with overlying epithelial and myoepithelial layers. These lesions can occur anywhere in the ductal system, and may be solitary or multiple (Warrick, 2011). It is founds typically beneath areola as mentioned by Lee at el (2011), and presents like a serous or bloody nipple discharge.

The risk of developing cancer from Intraductal papilloma is not well established, Azzopardi did not consider papilloma to be a direct precursor based on what he believed to be a false association between papilloma and breast cancer in studies available during his time, which he thought were confounded by an overdiagnosis of "pseudo-infiltration" in benign papilloma and the misdiagnosis of papilloma as papillary carcinoma. (Azzopardi, 1979). In the other hand, Haagensen believed "multiple papillomas" was a precancerous lesion; because all 6 women in his study who developed breast cancer, in the same area where the initial papilloma had been diagnosed. (Haagensen, 1986).

            Phyllodes tumor is the most commonly occurring nonepithelial neoplasm of the breast, presents like a large, bulky mass of connective tissue and cysts, leaf like projection, commonly in the 6^th decade of life (Lee, 2011), although it represents only about 1% of tumors in the breast. It has a smooth, sharply demarcated texture and typically is freely movable. It is a relatively large tumor, with an average size of 5cm. The etiology of phyllodes tumors is unknown. (Lannin, 2012).

The difficulty in distinguishing between fibroadenoma, benign phyllodes tumors, and malignant cystosarcoma phyllodes may be vexing for even the most experienced pathologist (Yohe & Yeh, 2008).

Bibliography

Azzopardi, J. (1979). Problems in breast pathology. In: Bennington J, ed. Major progress in Pathology. London, UK: Bailliere-Tindall.

Haagensen, C. (1986). Diseases of the Breast. 3ra ed. . Philadelphia, Pa: WB Saunders Co.

Lannin, D. R. (2012, Jan 6). medscape.com. Retrieved Jan 23, 2012, from Cystosarcoma Phyllodes: http://emedicine.medscape.com/article/188728-overview
Lee, T., Bushan, V., Tolles, J., & Hofmann, J. (2011). First AID for the USMLE step 1. usa: McGraw Hill.
Roubidoux, M. A. (2011, apr 12). Medscape.com. Retrieved jan 23, 2012, from breast fibroadenoma imaging: http://emedicine.medscape.com/article/345779-overview
Warrick, J. I. (2011, Sep 29). medscape.com. Retrieved Jan 23, 2012, from Pathology of small, Peripheral Intraductal Papillomas: http://emedicine.medscape.com/article/1873858-overview
Yohe, S., & Yeh, I. (2008). Missed diagnoses of phyllodes tumor on breast biopsy: pathologic clues to its recognition. Int J Surg Pathol. , Apr; 16 (2):137-42.